A large number of women attend Gynecology clinics with vaginal discharge and an equally large group ignores this symptom, which can be an indication of a serious health condition. Vaginal discharge can sometimes be normal or physiological. For instance women can have a clear discharge during ovulation, prior to periods and during sexual intercourse. In some women this can be a bit excessive and cause discomfort.
So when should one worry about vaginal discharge?
Broadly speaking if the discharge is not clear and mucus like or is associated with a bad odor, itching or abdominal pain, you should see a doctor.
What causes the discharge?
It is a combination of secretions from the cervix and uterus, exfoliated cells, exudate from the vagina and secretions from lubricating glands in the vagina. These individual components are in a delicate balance and control the vaginal environment with the help of lactobacilli, which is present in the vagina and has an important role to play in safeguarding against other infections.
Bacterial and fungal infections are very common. But they are a myriad of other causes that cause a vaginal discharge.
For instance in young girls, parasitic infestation can present as a itchy persistent discharge. Allergy to chemicals and soaps can cause an inflammation and discharge.
In women who are married and are sexually active, infections can be sexually transmitted from their partners. Men are sometimes completely asymptomatic with these infections .The acute phase with discharge and fever lasts a few days following which the infection can ascend to the uterus and pelvis. Chlamydia and gonorrhea are very common.
Another kind of infection, which is extremely common, is called vaginal thrush or candida infection. This usually happens frequently in women who are diabetic, during antibiotic use and or during periods of significant illness and poor immunity.It can also be sexually transmitted.
Pelvic tuberculosis can sometimes present as discharge with abdominal pain, it is extremely challenging to treat, when not treated at an early stage.
More importantly cervical cancer and uterine cancer can present as a blood stained discharge and for this reason this symptom should not be ignored.
What are the red flags when it comes to vaginal discharge?
Persistent discharge that does not settle in a few days
Blood stained discharge
Discharge in women over the age of 60 and postmenopausal women
What is the association between cancers and discharge?
Cancer of the cervix or neck of the womb can present as a blood stained discharge or persistent dirty discharge. At times a vaginal discharge is the only indicator of precancerous changes in the cervix.
Cancer of the womb also presents as a troublesome discharge especially in older women.
Cancer of the fallopian tube, a very rare kind of cancer, which is difficult to detect at an early stage can also present as copious discharge.
In all these cases the discharge is a blessing in disguise as it prompts the patient to seek early medical help and diagnosis.
What happens at the clinic, when a patient presents with discharge?
They will have an assessment like all gynecological patients. They will also have a swab taken and additional tests such as an ultrasound scan done if required.
Can we allow the discharge to settle and heal-itself?
Some times if the acute episode is quite severe it might leave a lot of scarring inside your abdomen and pelvis and this in turn will cause longstanding pelvic pain, difficulty in falling pregnant and may even cause ectopic pregnancies.
Does home remedy help vaginal discharge?
Once you have had an assessment by a gynecologist and the discharge is not anything to worry about, you can try a few self-help tricks.
Drinking plenty of probiotic drinks such as curd, buttermilk and yogurt helps thrush and simple discharge.Avoiding practices such as vaginal douching or washing the inside of the vagina with fancy perfumed liquids and sprays should be avoided. Some people have a latex allergy and using latex free condoms might make a huge difference.
Finally , it is our responsibility as patients to access good quality health information , keep informed and seek early medical help.